When policy makes safety worse
Three strikes and you are out! How a guideline meant to make maternity care safer undermined good communication.
The emotional costs of moving away from CTG use
Maternity professionals often find comfort, competence, and control in CTG monitoring. Transitioning to intermittent auscultation requires that we address these emotional attachments. My suggestions on how to achieve this are in this week’s blog.
Cerebral palsy after caesarean section
A new study examined neurological outcomes in children born via caesarean section due to non-reassuring fetal monitoring. They found no differences in the rates of neurological problems when compared with caesarean done for non-progressive labour. The authors conclusions implied one possible reason for this – but there are other ways to interpret these results.
Twenty fetal monitoring myths that won’t go away
Myths about fetal heart rate monitoring are plentiful. Here are twenty of them. Let me know if there are others you would like to see me tackle!
There’s an invisible human rights issue in maternity care – let’s talk about it
It’s time to highlight the serious issue of unconsented fetal monitoring during childbirth, and the widespread misinformation about its safety and efficacy. It’s time to fix the underlying causes – starting with how guidelines are applied in practice.
How the RANZCOG policy changed
Analysis of the RANZCOG Intrapartum Fetal Surveillance guideline reveals significant changes between the 3rd and 5th editions. Key improvements include clear responsibility shifts to clinicians, realistic evidence levels for CTG use, and better evidence organization regarding risk factors.
I’m 41 weeks pregnant. What’s the deal with CTG monitoring?
RANZCOG’s fifth edition guideline highlights prolonged pregnancy (over 41 weeks) as a risk factor for intrapartum fetal compromise. Low-grade evidence suggests a slight increase in the risk of brain injury for babies born after 41 weeks. The guideline sets out professional’s responsibilities to support women to make their own decisions about fetal monitoring methods.
Thanks 2025 – and now on to 2026!
In 2025, I published 46 blog posts attracted 26,800 readers, and had over a million views on Facebook. I have big plans for 2026 – read on to find out more. Subscribe so you don’t miss out on any of the new things!
There’s a new RANZCOG fetal monitoring policy: What do they get right and what do they get wrong?
The recent fifth edition of RANZCOG’s fetal monitoring guideline adopts a new approach, providing more accurate summaries of the quality of their evidence. Although it emphasises women’s autonomy, they have not quite completed the task of shifting decision-making from obstetricians.
Australian folks – are you interested in joining me in a workshop in the new year for a detailed look at how to apply the guideline to your practice?
Why artificial intelligence systems for fetal monitoring are so seductive to healthcare systems (and why that is a huge ethical problem)
Fetal heart rate monitoring traditionally involves professionals interpreting patterns, but technology has introduced complex, expensive systems aimed at improving outcomes. Despite this, there are ethical concerns regarding women’s consent and data use. The focus appears to prioritize cost reduction for healthcare systems over meaningful enhancements in maternal and fetal care outcomes.
Birth Small Talk 